PTSD in history, other cultures

[AmericanPride]

You may have trouble finding any information on this, simply because the definition of PTSD is itself pretty recent. I can name any number of PTSD-type cases from the Civil War in the US alone, and I'm also sure you could find a huge number of anecdotal stories from many cultures predating that.

I suspect (though I'm not an anthro type...Marc's better qualified to speak to this possibly) that many tribal cultures had their own cultural mechanisms to deal with what we now call PTSD. Warrior societies, vision/spirit quest rituals, and even something as seemingly unrelated as the berserkers might all have been tools to deal with those who were shocked or disturbed by combat. Some tribal cultures also had social "outs" for those who weren't keen on combat (and in many cases the actual demand for warriors was low enough that it was a self-selecting process).

Do you think American society in general lacks any of those "outs", whether for those who are not "keen on combat", or for those who have mental injuries because of combat?

[marct]

Do you think American society in general lacks any of those "outs", whether for those who are not "keen on combat", or for those who have mental injuries because of combat?

I'd second Tom's suggestion of looking at Rwanda and the Congo. There is also some very good material from South Africa.

Part of the problem with all of this is that the definition of PTSD is too fluffy - it's based on a phenotypic definition rather than on a neurological one. From my (rather limited) reading of the literature, PTSD appears to refer to a neurological process that bypasses the neo-cortex and stores memories, or associations, directly in the hipocampus of the brain (or, at least, with a strong connection to that area).

Let me tell you a story (Anthropologists are ALWAYS telling stories ). In a certain tribe living nowadays in South Africa and Tanzania, the manhood ritual involved circumcision - usually with a rather dull iron knife at the age of 12 or so. This was followed with a requirement hat the "candidate" stand immersed in a cold stream for about an hour or so. No, to my mind, having parts of your anatomy slowly sawed off and then being put into cold water for an hour or so will, in all probability, induce a major system shock. Someone who had a genetic predisposition to PTSD, i.e. a likelihood of pain bypassing their neo-cortex, would probably die as a result of this ritual. So, in his culture, PTSD would not be as prevalent as in other cultures that don't select against it.

Marc

[Vic Bout]

having parts of your anatomy slowly sawed off and then being put into cold water for an hour or so will, in all probability, induce a major system shock.

we call that "apply ice to affected area" IOT reduce swelling...and in all probability give it a little primitive novocain lovin'. I'm thinking I'd want the cold stream treatment prior to the, uh, surgical procedure.

As to the whole PTSD aspect of the thing….naw. Folks in the third world, dependant on culture, are pretty much programmed through repeated events and annealed to physical hardship. We’re just “softer” here for a variety of reasons….e.g. very few of us don’t kill/dress our food, air conditioning (cable TV, etc) is viewed as a right, not a privilege, and my $100 Doc Martins protect my feet way better than those ratty old flip flops. IMO physical “toughness” goes a long way in combating PTSD.

[Ken White]

IMO physical “toughness” goes a long way in combating PTSD.

and I'd add that mental toughness and /or being mildly sociopathic helps as much or more...

[Vic Bout]

, though I think I recall LTC(R) Grossman saying something about SOF guys being sociopaths....but sociopaths in a good, sheepdog-like way.

[Danny]

It seems to me that you have excluded some key factors by the way in which you have formulated the problem. I would suggest that you go back and think some about the boundary conditions you have given.

For instance, why does PTSD have to be related to industrialized warfare, or the West, or cultural constructs? Why can't it be related to the human psyche and the nature of extreme violence against others and what it does to the human spirit?

You're approaching the problem as a social scientist. Try to think outside your box and approach it as a theologian or psychologist. Think mind / heart / will / volition rather than moray / social framework / common deliverance of society / date and time.

Then, it might be that you are opposed to this given some set of pre-commitments you have, and I am not commenting on whether this is a good thing or not, just observing. The way you have formulated the problem is significant.

Another way of saying this might be as follows. You could take your thesis and conclude that since you have found evidence of ancient Japanese warriors who suffered from PTSD that it must therefore be related to warfare with a sword.

I'm not trying to be insulting, but rather just to challenge your basic set of presuppositions.

[Ken White]

, though I think I recall LTC(R) Grossman saying something about SOF guys being sociopaths....but sociopaths in a good, sheepdog-like way.

After all, we can't really bark; we gotta bite to get the point across to the wolves...

[davidbfpo]

A colleague and friend who worked in Cambodia, after the UN supervised election, approx. ten years ago, found that the whole nation has been traumatised.

I would suggest that PTSD features in machete conflicts, for example child soldiers in West Africa. Western knowledge of this is dependent on access, language skills etc (prompting what books are there in French, Algeria?). More likely is population movement to the West, so enabling visibility in their writings, asylum procedures (court proceedings eg Zimbabwe in the UK) and the work of such bodies as the UK (name unsure of) Medical Foundation for Victims of Torture.

davidbfpo

[Steve Blair]

, though I think I recall LTC(R) Grossman saying something about SOF guys being sociopaths....but sociopaths in a good, sheepdog-like way.

I think that's because to a great extent SOF has taken the place of warrior societies in what could be considered the military tribal culture.

Grossman has some interesting points, but he gets too wrapped up in himself at times (and some of his social guilt ideas) and misses some important considerations. If you look at many of the Plains Indian cultures, most of them had a warrior society (or two...or three) that served to 'select' the more combat-prone (and capable) members of the tribe to serve as what might be considered full-time combatants. They were often the first (and last) line of defense for the community. But within that framework there were cleansing rituals and ways of dealing with the effects of combat that we really no longer have (at least in what could be considered a formal, ritualized sense). In a related note, I've also seen commentary that direct flights from the combat zone to "home" with no decompression period have greatly accelerated the impact of PTSD-type issues. Sometimes it's worth remembering that WW2 guys had to (for the most part) take ships home...and had time with their buddies to talk about what they'd seen and done (if they so chose).

Most elite units develop similar rituals over time. One thing I'd be interested in seeing is a comparison of PTSD rates between members of SOG and (say) a line battalion in the 9th ID during 1969. On a side note, I seem to recall reading in a couple of places that the PTSD/combat fatigue rate skyrocketed in Vietnam during the drawdown...as combat became rarer (it might have been in Shay's first book, although I know Kieth Nolan has addressed this in a couple of his books in a slight way).

I don't think PTSD is related to industrialized warfare...at least not directly. I might be more inclined to suspect that its recognition and possible increase is due more to industrialized societies losing touch with their earlier coping mechanisms...but that's just a suspicion.

[Sergeant T]

The saying I recall hearing is toughness in another term for training and training is another term for reducing the unknowns. The unknowns become the psychological outliers that generate trauma. There does seem to be a correlation between level of training and incidence of PTSD.

I'm particularly interested in at what point does "PTSD" change from being a normal reaction to sustained stress, and start being a genuine disease.

The DSM IV distinguishes between Acute Stress Disorder and Post Traumatic Stress Disorder, with the main difference being duration of symptoms. I think the thing to remember is that trauma is relative. For lack of a better analogy, stress is an emotional gas that will expand to fill the volume of its container. Training, experience, toughness, or whatever you want to call it will give you a larger “container”. Also, I can’t find the citation, but recall reading the estimate that 30 to 35% of soldiers experience acute or chronic PTSD. The rate among cops is somewhere north of 40%.

[reed11b]

and I'd add that mental toughness and /or being mildly sociopathic helps as much or more...

Mental flexibility may be more accurate. PTSD appears to be a processing memory problem more then anything else at this point in time. There were a few references to the SF community and PTSD on this thread, however keep in mind that an SF trooper that is diagnosed w/ PTSD would lose his Top Secret clearance, and thus no longer be an SF trooper. This combined with the fantastic team support that SF enjoys likely has more to do with the lower SF PTSD rates then anything else. When question 21 is removed, I will be curious to see if SF reported PTSD rates go up. Army battlemind training is a fantastic tool btw, speaking of preventative measures. The military is making great strides and deserves recognition for there role in improving the care for everyone w/ PTSD. Army behavioral Health is tops in this field, better then the VA.
Reed
P.S. Adam L.'s comments on PTSD being a cluster of symptoms and that understanding of the root cause is scarce is true. Unfortunately the entire DSM-IV operates the exact same way. So singling out PTSD for this is a little irrational. Reminds me of continued attempts to peg ADD on bad parenting. PTSD exists and now we need to discover the root causes to the best of our ability.

[Jayhawker]

I have to be honest and say that I've not read it, but Roger Spiller, formerly a Prof at CGSC, thinks very highly of Ben Shephard's "A War of Nerves" Harvard Univ Press, 2001. Shephard focuses on 20th century soldiers so the book runs the gamut from WWI to the Faulklands and includes WWII Army Air Forces. Shephard "writes widely on psychiatry and its history," according to the book blurb.

Ben

[Tom Odom]

I have to be honest and say that I've not read it, but Roger Spiller, formerly a Prof at CGSC, thinks very highly of Ben Shephard's "A War of Nerves" Harvard Univ Press, 2001. Shephard focuses on 20th century soldiers so the book runs the gamut from WWI to the Faulklands and includes WWII Army Air Forces. Shephard "writes widely on psychiatry and its history," according to the book blurb.

Ben

That makes sense. Roger was and is very big on the mental aspects and effects of combat/war. Jerry Linderman is another I wouuld recommend.

Tom